NEW PATIENTS
NEW PATIENT FORMS
SCHEDULE ONLINE by clicking Book Appointment!
Click on the button below for New Patient Forms you can download, print and complete before your first scheduled dentist appointment with Bondurant Family Dentistry. We look forward to meeting you!
PAYMENT METHODS
We hope to accommodate your dental care with a wide variety of options for payment. Reviewing the information below will help match you with your preferred payment method.
ACCEPTED INSURANCE
We accept insurance from a wide range of providers for your convenience. We’ll work to help you coordinate your care with your insurance provider. If you carry dental insurance, please check the list below for your provider:
Ameritas
Anthem BCBS
Associated Benefits Corporation
Benefits Management Group
Blue
Blue Cross Blue Shield
Cash
Cypress Benefit Admin
Delta
Employee Benefits System
Formula Dental
John Deere UHC
Meritian Health
Principal
Reliance Standard
Team Care
UMR
Unions
Wellmark
Administrative Concepts
American Republic
Blue Care Dental
Central States Services
Cigna
Custom Design
Dearborn National
Dentemax
GEHA
Health Partners of MN
Humana
Indiana State Roofers
LineCo Benefit
MetLife
Physicians Mutual
United Concordia
UNUM
Wilson McShane
Aetna
Assurant
BCBS FEP
Best Lite
Coventry
Guardian
Health Scope
Kansas City Life
Lincoln Financial Group
MCNA
Sun Lite Financial
UHC (Not John Deere)
United Concordia
Wellness
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CREDIT CARDS
At Bondurant Family Dentistry you’re able to use your major credit card to cover your expenses. We accept all major credit cards including Visa, MasterCard, American Express, and Discover.
FINANCING
Instead of putting off needed dental care, Care Credit is an option for those who qualify for these flexible monthly payments. With qualification, CareCredit offers no interest if paid in full in 6, 12, 18 or 24 month* with their promotional financing options. Please read and understand the CareCredit terms and financing options. CareCredit promotional financing options may expire at any time. Bondurant Family Dentistry is not affiliated with CareCredit.
Visit www.carecredit.com for more information, or click the CareCredit icon on your Mountain Dental office page to apply now.
FREQUENTLY ASKED QUESTIONS
Then you can get a head start by clicking on the ‘NEW PATIENT HEALTH HISTORY AND HIPAA’ button under ‘NEW PATIENT FORMS’ above to download, print and fill in your information before your visit.
You can walk in to get the form, we can fax or email it to you, or you can click on the ‘CONSENT TO RELEASE RECORDS’ above and download, print, fill in and then submit the form to our office in order for us to obtain your previous records.
Long-term dental anxiety can lead to oral health problems resulting from avoiding the dentist.
We can also offer to administer nitrous oxide, known as “laughing gas,” or we can prescribe other remedies to reduce your anxiety.
Gum disease is silent like diabetes and high blood pressure until it’s too late. The good news is that routine dental care can help prevent it!
We will listen to you when you share about your dental issues and will ask thoughtful questions for further assessment. Then simple or phased treatment plans are developed with your involvement. Open, honest, productive communication with our patients is our Standard of Care.